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1.
Eur Neurol ; 69(5): 289-91, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23445663

RESUMO

OBJECTIVES: We analyzed the diagnoses of patients consulting due to strictly unilateral headaches. METHODS: We prospectively collected data from 100 consecutive patients. Diagnosis followed the ICHD-II criteria. RESULTS: They accounted for 18.9% of the 528 patients seen in the study period. They were more frequent in males (58%). Age ranged from 19 to 81 years. Diagnostic distribution was: cluster headache (38 cases), a variety of secondary headaches (14 cases), migraine (11 cases), cervicogenic headaches (9 cases), hemicrania continua (8 cases), nummular headache (6 cases), psychiatric headache (5 cases), paroxysmal hemicranias (4 cases), short-lasting unilateral neuralgiform headache attacks syndrome (3 cases), stabbing headache (1 case), and hypnic headache (1 case). Mean ages at onset fell between 47 and 58 years for several diagnoses (cervicogenic, nummular, psychiatric, hemicrania continua and paroxysmal hemicrania headaches), and were 22 years for migraine, 32 for cluster and in general older than 55 years for secondary headaches. CONCLUSIONS: Strictly unilateral headaches account for almost 20% of headaches in subjects attending a headache clinic. Trigeminal-autonomic cephalgias in general (52%) and cluster headache in particular (38%) are the most frequent diagnoses, but secondary headaches account for 1 of 5 cases. Age at onset can be of help in their presumptive diagnosis.


Assuntos
Cefaleia/diagnóstico , Cefaleia/terapia , Manejo da Dor/métodos , Encaminhamento e Consulta , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Cefaleia/classificação , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
2.
Nutr Hosp ; 24(2): 200-6, 2009.
Artigo em Espanhol | MEDLINE | ID: mdl-19593492

RESUMO

INTRODUCTION: The population of Guadalajara traditionally has consumed a Mediterranean diet with the typical variations of the central zone of the peninsula, but the acquisition of erroneous habits of life they can be translated, specially in the young people, in a not healthful nourishing conducts. OBJECTIVE: To evaluate the quality of the diet, by means of an index of healthy nourishment (IAS) and percentage of adhesion to the Mediterranean diet (% ADM), of a teen population (n = 467) and their relation with different physiological parameters and sociodemográficos. METHOD: A nutritional study has been realized on the quality of the diet in a teen population of Guadalajara of 467 young people (12-17 years) by means of questionnaires of frequency of consumption of seven days. Likewise, there has determined the ingestion of nutrients and the index of healthy nourishment (IAS) using the program of nutrition DIAL(c). RESULTS: The results show that the average of the population takes a diet with an acceptable IAS (62.78), though with trend towards low qualities, with high ingestions of saturated fats (38.90 +/- 6.58 g), cholesterol (384.69 +/- 74.24 mg) and sodium (3,395.43 +/-729.57 mg). Respect to % MDA there has been obtained an average value of 42.86 +/- 15.52%. These values differ depending on the age (improves with the age), the sex (better quality of the diet consumed by the girls). Likewise, all the factors sociodemográficos and the way of life considered, they influence the quality indicators used.


Assuntos
Dieta/normas , Adolescente , Criança , Feminino , Humanos , Masculino , Espanha
3.
J Clin Invest ; 75(1): 226-33, 1985 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-3880773

RESUMO

We performed immunoperoxidase stains on skin biopsies taken from nine patients with recurrent peripheral herpes simplex lesions at 12 h to 6 d after onset of signs of symptoms to phenotype the inflammatory infiltrate, to detect cells producing interferons alpha and gamma, and to locate herpes simplex virus antigen-containing cells. Viral glycoprotein antigen was located in the nuclei and cytoplasm of necrotic epidermal cells, often within vesicles, in biopsies taken between the first and third day. Histologically, biopsies of all stages showed intradermal focal perivascular and diffuse mononuclear inflammatory infiltrates. The cells constituting the infiltrates were predominantly T lymphocytes with lesser numbers of histiocytes; Leu 7+ (most natural killer/killer) cells and B cells were rare in the biopsy specimens. Leu 3a+ ("helper") T lymphocytes predominated in both subepidermal and perivascular regions of early lesions (12-24 h). Tissue helper/suppressor ratios ranged from 6.3 to 3.4 compared with 1.9-1.0 in blood. In later lesions (after 2 d), monocytes/macrophages were more prominent in tissue sections and the helper/suppressor ratios (2.3-2.5) more nearly approximated those of blood (1.6-2.7). The negative correlation of tissue ratios with time was significant (P less than or equal to 0.02). A large proportion of the infiltrated T lymphocytes expressed DR antigens. There was also diffuse strong DR expression on epidermal cells in five cases (all of two or more days). In six biopsies, scattered macrophages and small cells, presumably lymphocytes, demonstrated cytoplasmic or membrane staining for a substance which copurifies with interferon gamma. We identified such stained cells within vessels, suggesting that these cells circulate. Gamma interferon might have an important role within the herpetic lesions, possibly inducing macrophage activation and cytotoxic T lymphocytes and increasing DR expression on monocyte and epidermal cells.


Assuntos
Herpes Simples/patologia , Adulto , Biópsia , Herpes Simples/genética , Herpes Simples/imunologia , Humanos , Técnicas Imunoenzimáticas , Fenótipo
4.
Ann Nutr Metab ; 51(5): 402-6, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17851234

RESUMO

BACKGROUND: Metabolic syndrome is a clinical disorder that is becoming more prevalent in Spain. The syndrome encompasses a set of metabolic disorders such as type-2 diabetes mellitus, hypertension, dyslipidemia, and obesity, which may be associated with variations in serum levels and poor delivery of certain mineral elements. METHODS: This study attempted to ascertain whether metabolic syndrome might be linked to alterations in serum levels of the mineral elements magnesium, copper, zinc, chromium, and nickel in a population of 92 diabetic subjects, some suffering from certain conditions associated with the metabolic syndrome, and 72 control subjects (Hospital Príncipe de Asturias, Alcalá de Henares, Spain). RESULTS: The results indicated that as a group the alterations implicated in metabolic syndrome were indeed associated with variations in blood levels of the mineral elements considered, though statistically significant differences were recorded only in the case of copper. Still, trends in mineral levels for each of the separate components contributing to the syndrome tended to increase. CONCLUSION: Metabolic complications appear to be associated with alterations in the levels of some minerals, especially copper.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Síndrome Metabólica/sangue , Minerais/sangue , Estudos de Casos e Controles , Cromo/sangue , Cobre/sangue , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Magnésio/sangue , Masculino , Síndrome Metabólica/etiologia , Pessoa de Meia-Idade , Níquel/sangue , Zinco/sangue
5.
Nutr Hosp ; 21(6): 709-14, 2006.
Artigo em Espanhol | MEDLINE | ID: mdl-17147071

RESUMO

ANTECEDENTS: Commercialized like dietetic supplement, chromium picolinate has been promoted to favour the increase of muscle mass and the loss of weight, due to its' effect on the action of insulin. OBJECTIVE: To evaluate the effect of supplementation of the diet with chromium (500 microg/kg) in the form of chromium picolinate (CrPic) (12 days) on growth and protein turnover in rats at different growth stages (infantile and puberal). RESULTS AND DISCUSSION: No significant effect of CrPic on bodyweight gain, feed intake and feed conversion rate was observed at any of the stages of development studied. CrPic seems to increase the muscle mass, either by stimulating protein anabolism due to the involution of the insulin by chromium, or by reducing protein catabolism. CONCLUSIONS: Since the use of chromium picolinate could jeopardize the correct renal function and its' beneficial effects are not evident, it should always be consumed with caution.


Assuntos
Crescimento e Desenvolvimento/efeitos dos fármacos , Ácidos Picolínicos/farmacologia , Fatores Etários , Animais , Suplementos Nutricionais , Masculino , Proteínas/efeitos dos fármacos , Proteínas/metabolismo , Ratos , Ratos Wistar
6.
Arch Intern Med ; 144(3): 615-7, 1984 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-6322711

RESUMO

A case of invasive cutaneous Trichophyton rubrum infection complicated the course of a patient undergoing chemotherapy for acute lymphocytic leukemia. This dermatophytic disease was well controlled with ketoconazole. Prior experience with these unusual infections is summarized.


Assuntos
Cetoconazol/uso terapêutico , Tinha/tratamento farmacológico , Humanos , Leucemia Linfoide/complicações , Leucemia Linfoide/tratamento farmacológico , Masculino , Mercaptopurina/uso terapêutico , Pessoa de Meia-Idade , Prednisona/uso terapêutico , Tinha/complicações , Tinha/patologia
7.
AIDS ; 7(12): 1607-11, 1993 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-8286070

RESUMO

OBJECTIVE: To examine the stability of cognitive function in patients with asymptomatic HIV infection. DESIGN: Previous longitudinal studies of cognitive function have focused on patients who progress in terms of disease stage. The present study avoided this potential confounding factor by including only subjects who remained in the asymptomatic stage of infection over the follow-up period. METHOD: Subjects were administered an extensive neuropsychological test battery at baseline and 1 year follow-up. Overall performance was characterized as normal or abnormal based on the performance of a well-matched HIV-negative control group. RESULTS: A significantly higher proportion of HIV-positive subjects became abnormal at the follow-up examination. Comparison of the seropositive subjects who remained normal with those who became abnormal revealed no differences at baseline on age, education, depression or CD4 levels. Subjects who became abnormal had worse performance at baseline on measures of information processing, verbal learning and memory, and reaction time. CONCLUSIONS: These data indicate that cognitive function may decline in some patients who continue to be in the asymptomatic stage of infection. Patients with a pattern of cognitive abnormalities at baseline, which includes information processing and reaction time deficits, may be at increased risk for declines in function during early stages of infection.


Assuntos
Transtornos Cognitivos/etiologia , Infecções por HIV/psicologia , Adulto , Humanos , Masculino , Testes Neuropsicológicos
8.
AIDS ; 7(4): 519-24, 1993 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-8507418

RESUMO

OBJECTIVE: To examine cognitive function in patients at various stages of HIV infection, and to determine the nature and severity associated with stage of illness. DESIGN: Subjects were administered an extensive battery of neuropsychological tests. SUBJECTS: Two hundred and thirty-three HIV-1-infected homosexual/bisexual men and 77 HIV-negative control subjects who had been screened for previous neurological illness. All subjects were volunteers in a longitudinal study of neurobehavioral complications of HIV infection. RESULTS: Patients with symptomatic infection differed from controls on a large number of measures, and asymptomatic patients had a more circumscribed pattern of deficit. On a summary measure of cognitive impairment, there was a twofold increase in the prevalence of impairment in asymptomatic patients relative to controls, and a fourfold increase in symptomatic patients. Memory and dexterity problems appear to be early features of neurobehavioral dysfunction, and frontal lobe deficits were found in patients with symptomatic infection. CONCLUSION: These data indicate that there is a steady increase in the prevalence of neurobehavioral abnormalities associated with stage of infection. The pattern of abnormality also varies with disease stage.


Assuntos
Cognição , Infecções por HIV/psicologia , HIV-1 , Síndrome da Imunodeficiência Adquirida/psicologia , Adulto , Infecções por HIV/classificação , Soropositividade para HIV/psicologia , Humanos , Masculino , Testes Neuropsicológicos
9.
AIDS ; 15(6): 693-701, 2001 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-11371683

RESUMO

OBJECTIVES: The purpose of the study was to examine the effects of aerobic exercise on physiological fatigue (time on treadmill), dyspnea [rate of perceived exertion (RPE) and forced expiratory volume at 1 s (FEV1)], weight, and body composition in HIV-1-infected adults (200-499 x 106 CD4+ cells/l). DESIGN: The study was a randomized, wait-listed, controlled clinical trial of aerobic exercise in HIV-1-infected adults on signs and symptoms associated with HIV-1 infection or its treatment. METHODS: Sixty subjects were recruited and randomized to two groups. Experimental subjects completed a 12-week supervised exercise program. Control subjects continued usual activity from baseline to week 12 and were then were enrolled in the exercise program. RESULTS: At baseline, the groups were similar in age, weight, body mass index [mean body mass index (BMI) > 27], time since diagnosis, number of symptoms, CD4+ cell count, and number on protease inhibitor therapy (n = 7). Despite disproportionate attrition from the exercise group (38%), exercise subjects were able to remain on the treadmill longer, lost weight, decreased BMI, subcutaneous fat, and abdominal girth when compared to controls. The improvement in weight and body composition occurred without a decrease in kilocalories consumed. Exercise did not seem to have an effect on RPE, a surrogate for dyspnea, and FEV1. There was no significant difference in either the change in CD4+ cell count, percentage or copies of plasma HIV-1 RNA between groups. CONCLUSIONS: We conclude that supervised aerobic exercise training safely decreases fatigue, weight, BMI, subcutaneous fat and abdominal girth (central fat) in HIV-1-infected individuals. It did not appear to have an effect on dyspnea.


Assuntos
Composição Corporal , Peso Corporal , Dispneia , Exercício Físico , Fadiga , Infecções por HIV/terapia , Adulto , Índice de Massa Corporal , Contagem de Linfócito CD4 , Dispneia/etiologia , Teste de Esforço , Fadiga/etiologia , Feminino , Volume Expiratório Forçado , Infecções por HIV/complicações , Infecções por HIV/fisiopatologia , Humanos , Masculino , Consumo de Oxigênio , RNA Viral/sangue , Carga Viral , Listas de Espera
10.
Am J Psychiatry ; 150(6): 922-7, 1993 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-8494070

RESUMO

OBJECTIVE: The authors examined the effect of depression on neuropsychological performance in HIV-infected men. Previous studies have suggested that depression may account for the neuropsychological abnormalities observed in some patients with HIV infection, but few studies have specifically examined this question. METHOD: An extensive neuropsychological test battery was administered to 121 HIV-seropositive asymptomatic men and 42 HIV-seronegative comparison subjects. The seropositive subjects were grouped into depressed and non-depressed groups on the basis of scores on the Beck Depression Inventory, Hamilton Rating Scale for Depression, and Structured Clinical Interview for DSM-III-R. RESULTS: Statistical comparisons revealed very few measures on which the depressed seropositive subjects scored significantly worse than either of the nondepressed comparison groups. The nondepressed seropositive group differed consistently from the seronegative comparison subjects on measures of verbal memory and dexterity. CONCLUSIONS: These data indicate that the subtle neuropsychological abnormalities observed in some asymptomatic HIV-seropositive subjects cannot be attributed to depression. These data also indicate the advantages of a multifaceted approach to assessment of depression.


Assuntos
Transtorno Depressivo/diagnóstico , Soropositividade para HIV/diagnóstico , Testes Neuropsicológicos , Adulto , Fatores Etários , Relação CD4-CD8 , Comorbidade , Transtorno Depressivo/epidemiologia , Diagnóstico Diferencial , Escolaridade , Soropositividade para HIV/epidemiologia , Soropositividade para HIV/imunologia , Humanos , Masculino , Inventário de Personalidade , Escalas de Graduação Psiquiátrica , Teste de Sequência Alfanumérica
11.
Arch Neurol ; 48(7): 704-7, 1991 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-1677559

RESUMO

This study examined the relationship between performance on a battery of neuropsychologic tasks and rate of CD4 lymphocyte decline in 47 gay or bisexual men infected with the human immunodeficiency virus type 1. Subjects were volunteers for a longitudinal study of the human immunodeficiency virus infection and were not selected because of neuropsychiatric symptoms. Subjects were at all stages of illness, although most were asymptomatic. Faster rates of decline in percent CD4 lymphocyte were related to poorer performance on measures of memory and reaction time. This relationship was independent of stage of illness and CD4 level at the time of neuropsychologic examination, and was not due to medication effects. The rate of percent CD4 lymphocyte cell loss is associated with and may represent a risk factor for the development of the human immunodeficiency virus-related neurobehavioral deficit.


Assuntos
Linfócitos T CD4-Positivos , Infecções por HIV/imunologia , Contagem de Leucócitos , Testes Neuropsicológicos , Adulto , Infecções por HIV/psicologia , Humanos , Masculino , Memória , Tempo de Reação
12.
Antivir Ther ; 5(1): 41-8, 2000 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-10846592

RESUMO

To assess the relation between resistance to antiretroviral drugs for treatment of HIV-1 infection and virological response to therapy, results from 12 different studies were re-analysed according to a standard data analysis plan. These studies included nine clinical trials and three observational cohorts. The primary end-point in our analyses was virological failure by week 24. Baseline factors that were investigated as predictors of virological failure were plasma HIV-1 RNA, the number and type of new antiretroviral drugs in the regimen, and viral susceptibility to the drugs in the regimen, determined by genotyping or phenotyping methods. These analyses confirmed the importance of both genotypic and phenotypic drug resistance as predictors of virological failure, whether these factors were analysed separately or adjusted for other baseline confounding factors. In most of the re-analysed studies, the odds of virological failure were reduced by about twofold for each additional drug in the regimen to which the patient's virus was sensitive by genotyping methods, and by about two- to threefold for each additional drug that was sensitive by phenotyping.


Assuntos
Fármacos Anti-HIV/farmacologia , Interpretação Estatística de Dados , Infecções por HIV/tratamento farmacológico , HIV-1/efeitos dos fármacos , Inibidores da Transcriptase Reversa/farmacologia , Fármacos Anti-HIV/uso terapêutico , Ensaios Clínicos como Assunto , Estudos de Coortes , Resistência Microbiana a Medicamentos/genética , Quimioterapia Combinada , Genótipo , Infecções por HIV/virologia , HIV-1/genética , Humanos , Testes de Sensibilidade Microbiana/métodos , Fenótipo , Estudos Prospectivos , RNA Viral/sangue , Estudos Retrospectivos , Inibidores da Transcriptase Reversa/uso terapêutico , Resultado do Tratamento
13.
AIDS Res Hum Retroviruses ; 16(14): 1337-44, 2000 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-11018853

RESUMO

Nucleoside analog-based regimens remain an integral component of combination therapy for use in both antiretroviral treatment-naive and experienced HIV-infected patients. To further define treatment responses to new antiretroviral therapy in patients with long-term experience to dual nucleoside analog therapy (zidovudine [ZDV] plus didanosine [ddI] or ZDV plus zalcitabine [ddC]), 325 subjects derived from the AIDS Clinical Trials Group (ACTG) 175 trial were randomized to three different combination regimens: (1) continuation of ZDV + ddI or ZDV + ddC (continuation arm), (2) addition of 3TC to ZDV + ddI or ZDV + ddC (addition arm), or (3) a switch to ZDV + 3TC therapy (switch arm). Both the addition and switch arms sustained significantly greater short-term (baseline to week 4) mean CD4+ cell count increases compared with the continuation arm (+36, +28 versus -4 cells/mm3; p = 0.012) and long-term CD4+ cell count responses (baseline to weeks 40/48: +32, +19 versus -9 cells/mm3; p = 0.003). Superior short-term (baseline to week 8) mean decreases in plasma HIV RNA (p < 0.001) were achieved by both the addition and switch arms (0.53 log10 and 0.54 log10 copies/ml, respectively) compared with the continuation arm (0.13 copies/ml) whereas no differences in long-term virologic suppression were observed (p = 0.30). At week 48, no differences were observed in the proportions of subjects who had HIV RNA levels below 500 copies/mL: 18% of subjects in each treatment arm (3-way p = 1.0). Overall, the treatments were well tolerated and only nine subjects (3%) died or developed one or more AIDS-defining events. While this study confirms the intrinsic antiretroviral activity of 3TC, only modest marker changes and limited short-term viral suppression are seen with incremental addition of the drug. The current approach of using 3TC in maximally suppressive regimens is preferred.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , HIV-1 , Lamivudina/uso terapêutico , Inibidores da Transcriptase Reversa/uso terapêutico , Adulto , Contagem de Linfócito CD4 , Didanosina/uso terapêutico , Quimioterapia Combinada , Feminino , Infecções por HIV/virologia , HIV-1/isolamento & purificação , HIV-1/fisiologia , Humanos , Masculino , RNA Viral/sangue , Resultado do Tratamento , Zalcitabina/uso terapêutico , Zidovudina/uso terapêutico
14.
AIDS Res Hum Retroviruses ; 17(3): 203-10, 2001 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-11177402

RESUMO

To optimize nucleoside reverse transcriptase inhibitor (nRTI) antiretroviral therapy, 137 subjects who had been treated with didanosine monotherapy for more than 3 years in the AIDS Clinical Trials Group (ACTG) 175 study were randomized to zidovudine and didanosine (dual therapy) or zidovudine, didanosine, and lamivudine (triple therapy). Evaluation of early (8 week) change in HIV plasma RNA demonstrated that addition of lamivudine and zidovudine provided significantly greater virologic suppression compared to the addition of zidovudine alone (mean decrease of 1.27 vs. 0.74 log(10) copies/ml, n = 108, p = 0.007). Both dual and triple therapy provided significant long-term decreases (from study entry to mean at Weeks 40 and 48) in HIV plasma RNA: 0.62 and 0.86 log(10) copies/ml, respectively (n = 110). However, the difference between treatments was not significant (p = 0.16). At 48 weeks, 26% of subjects starting study treatment had <500 copies/ml of plasma HIV RNA. The CD4 count response was greater at 4 weeks for triple versus dual therapy: a mean increase of 51 vs. 12 CD4 cells/ml(3) (n = 126, p = 0.039). The difference at Weeks 40 and 48 was not significant (a 22 cell increase vs. a 1 cell decrease, n = 129, p = 0.41). Zidovudine and didanosine treatment, with or without lamivudine, was well tolerated and only 2 of 137 (1.5%) of study participants developed an AIDS-defining event over 48 weeks.


Assuntos
Didanosina/uso terapêutico , Infecções por HIV , Lamivudina/uso terapêutico , Inibidores da Transcriptase Reversa/uso terapêutico , Zidovudina/uso terapêutico , Adulto , Contagem de Linfócito CD4 , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/imunologia , Infecções por HIV/virologia , Humanos , Masculino , Pessoa de Meia-Idade , RNA Viral/sangue , Resultado do Tratamento
15.
AIDS Res Hum Retroviruses ; 16(11): 1031-7, 2000 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-10933617

RESUMO

Clinical benefit of zidovudine alone in the treatment of HIV infection wanes after several years, with decreasing CD4+ cell numbers and increasing HIV RNA in plasma. To develop treatment strategies following prolonged zidovudine treatment, 92 subjects from the AIDS Clinical Trials Group (ACTG) 175 study after a median of 3.6 years of zidovudine monotherapy were randomized to treatment with stavudine or zidovudine and lamivudine. Evaluation of long-term changes, the average of 40- and 48-week HIV plasma RNA, demonstrated that lamivudine and zidovudine provided significantly greater virologic suppression compared with stavudine (mean decrease 0.70 versus 0.18 1og10 copies/ml,p = 0.003). Twenty-nine percent of zidovudine plus lamivudine recipients had HIV RNA levels below 500 copies per milliliter at 48 weeks as compared with 4% of stavudine recipients (p = 0.02). Both regimens significantly increased CD4+ cell numbers, the means of weeks 40 and 48 rose to 49 and 36 CD4+ cells per cubic millimeter among zidovudine plus lamivudine and stavudine recipients, respectively. Treatments were well tolerated and only 3 of 92 subjects died or developed AIDS within 48 weeks. In zidovudine-experienced subjects, addition of lamivudine resulted in significantly decreased plasma HIV RNA levels at 48 weeks compared with treatment with stavudine alone.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Contagem de Linfócito CD4 , Infecções por HIV/tratamento farmacológico , HIV-1/fisiologia , Inibidores da Transcriptase Reversa/uso terapêutico , Adulto , Terapia Antirretroviral de Alta Atividade , Método Duplo-Cego , Esquema de Medicação , Feminino , Infecções por HIV/imunologia , Infecções por HIV/virologia , HIV-1/efeitos dos fármacos , Humanos , Masculino , RNA Viral/sangue , Resultado do Tratamento , Carga Viral
16.
Antiviral Res ; 45(1): 47-58, 2000 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10774589

RESUMO

RATIONALE: To determine the dosage requirements and pharmacokinetics of atevirdine, a non-nucleoside reverse transcriptase inhibitor and its N-dealkylated metabolite (N-ATV) during phase I studies in patients receiving atevirdine alone or in combination with zidovudine. DESIGN: Two open label, phase I studies conducted by the adult AIDS Clinical Trials Group (ACTG) in which atevirdine was administered every 8 h with weekly dosage adjustments to attain targeted trough plasma atevirdine concentrations. SETTING: Five Adult AIDS Clinical Trials Units. PATIENTS: Fifty patients (ACTG 199; n = 20 and ACTG 187; n = 30) with HIV-1 infection and < or =500 CD4+ lymphocytes/mm3. INTERVENTION: ACTG 199; 12 weeks of therapy with atevirdine (dose-adjusted to achieve plasma trough atevirdine concentrations of 5-10 microM) and zidovudine (200 mg every 8 h). ACTG 187: 12 weeks of atevirdine monotherapy with atevirdine doses adjusted to achieve escalating, targeted trough plasma concentration ranges (5-13, 14-22, and 23-31 microM). MEASUREMENTS: ACTG 199: atevirdine, N-ATV and zidovudine trough determinations weekly (all patients) and intensive pharmacokinetics (selected patients) prior to and at 6 and 12 weeks during combination therapy. ACTG 187: atevirdine and N-ATV trough concentrations over a 12 week period. Intensive pharmacokinetic studies were conducted prior to and at 4 and/or 8 weeks during atevirdine monotherapy in female patients. RESULTS: Atevirdine plasma concentrations demonstrated considerable interpatient variability which was minimized by the adjustment of maintenance doses (range: 600-3900 mg/day) to achieve the desired trough concentrations. In ACTG 187, the mean number of weeks to attain the target value, and the percentage of patients who attained the target, was group I (5-11 microM): 2.7+/-2.4 weeks (92%); group II (12-21 microM): 2.6+/-1.8 (64%); and group III (22-31 microM): 7.0+/-5.6 weeks (27%). In ACTG 199 it was 3.2+/-5.2 weeks (95%) to achieve a 5-10 microM trough. Atevirdine demonstrated a mono- or bi-exponential decline among most of the patients studied after the first dose. During multiple-dosing a number of patterns of atevirdine disposition were observed including; rapid absorption with Cmax at 0.5-1 h, delayed absorption with Cmax at 3-4 h; minimal Cmax to Cmin fluctuation and Cmax to Cmin ratios of > 4. N-ATV (an inactive metabolite) patterns were characterized on day one by rapid appearance of the metabolite which peaked at 2-3 h after the dose and declined in a mono- or bi-exponential manner. At steady-state N-ATV patterns demonstrated minimal Cmax to Cmin fluctuations with some of the patients having more stable plasma N-ATV concentrations, while others had greater fluctuations week to week. CONCLUSIONS: Considerable interpatient variability was noted in the pharmacokinetics of atevirdine. The variation in drug disposition was reflected in the range of daily doses required to attain the targeted trough concentrations. Atevirdine metabolism did not appear to reach saturation during chronic dosing in many of our patients, as reflected by the pattern of N-ATV/ATV ratios in plasma and saturation was not an explanation for the variation in dosing requirements. No apparent differences were noted between males and females, and atevirdine did not appear to influence zidovudine disposition.


Assuntos
Fármacos Anti-HIV/administração & dosagem , Fármacos Anti-HIV/farmacocinética , Infecções por HIV/tratamento farmacológico , HIV-1 , Piperazinas/administração & dosagem , Piperazinas/farmacocinética , Adulto , Fármacos Anti-HIV/sangue , Área Sob a Curva , Feminino , Infecções por HIV/metabolismo , HIV-1/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Piperazinas/sangue , Inibidores da Transcriptase Reversa/administração & dosagem , Inibidores da Transcriptase Reversa/sangue , Inibidores da Transcriptase Reversa/farmacocinética , Caracteres Sexuais , Zidovudina/administração & dosagem , Zidovudina/farmacocinética
17.
J Infect ; 22(1): 41-4, 1991 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-1900521

RESUMO

Patients with acquired immunodeficiency syndrome (AIDS) are at risk from many endocrine complications. Pentamidine has been recognised for its potential to cause symptomatic, and even life-threatening hypoglycaemia. We report two cases of diabetes mellitus presenting with ketoacidosis 3 to 4 months after pentamidine therapy for Pneumocystis carinii pneumonia (PCP), and review our experience of dysglycaemia in 58 patients with AIDS treated with pentamidine. These cases emphasise the potential for severe pancreatic toxicity in patients with AIDS. Hyperglycaemia during pentamidine therapy may be a marker for patients at increased risk of developing diabetes mellitus.


Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Cetoacidose Diabética/induzido quimicamente , Pentamidina/efeitos adversos , Adulto , Complicações do Diabetes , Cetoacidose Diabética/complicações , Humanos , Hipoglicemia/induzido quimicamente , Hipoglicemia/complicações , Insulina/uso terapêutico , Masculino , Pessoa de Meia-Idade , Pneumonia por Pneumocystis/tratamento farmacológico , Fatores de Tempo
18.
J Trace Elem Med Biol ; 12(3): 155-8, 1998 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-9857328

RESUMO

One of the parameters related to the development of coronary disease in diabetic patients is the tissular Zn/Cu ratio. We evaluated the levels of Zn and Cu, and the Zn/Cu ratio in insulin target tissues in diabetic and normoglucemic growing Wistar rats in order to determine the influence of diabetes and the disease evolution period. Diabetes was induced chemically by administration of streptozotocin. In order to determine the influence of the duration of diabetes on the Zn/Cu ratio, three time periods were studied: 7, 21 and 60 days. The animals were subsequently sacrificed and the target tissues (liver, adipose tissue, and skeletal muscle) were removed. Zn and Cu levels were measured by AAS after wet mineralization. STZ-induced diabetes modified the tissular Zn and Cu content. There was a significant decrease (p < 0.01) in liver and adipose tissue, but not in skeletal muscle. The in adipose tissue and skeletal muscle, but not in liver, effects were dependent on the duration of diabetes. The Cu content was higher in the liver of diabetic rats (p < 0.1) and lower in adipose tissue (p < 0.1) and skeletal muscle (NS). Tissular Cu levels also were affected significantly by the duration of diabetes. The Zn/Cu ratio showed a generalized decrease, except in skeletal muscle. This decrease was dependent on the presence of diabetes mellitus and the duration of the disease (p < 0.01).


Assuntos
Cobre/metabolismo , Diabetes Mellitus Experimental/metabolismo , Zinco/metabolismo , Animais , Cobre/análise , Fígado/metabolismo , Masculino , Músculo Esquelético/metabolismo , Especificidade de Órgãos , Ratos , Ratos Wistar , Valores de Referência , Zinco/análise
19.
Nutr Hosp ; 10(6): 373-6, 1995.
Artigo em Espanhol | MEDLINE | ID: mdl-8599624

RESUMO

Chromium picolinate has been implicated as a lipid and carbohydrate reducing agent, and therefore it may be a valuable adjunct to the treatment and prevention of diabetes and heart disease. This compound is inexpensive and apparently nontoxic. In this work, we have determined the influence of its administration (100, 200, 500 micrograms Cr/ml, for 7 and 21 days) on hepatic content of Zn, Mn, Cu and Fe of male Wistar rats. The results show a variation of the levels of these elements after the administration of chromium picolinate, although the differences are only significantly (p < 0.01) in the case of Mn. This influence is dose-dependent, occurring a decrease of 72% in the group treated with 500 micrograms/ml (Pic-500) respect to the content of control group.


Assuntos
Quelantes de Ferro/farmacologia , Fígado/efeitos dos fármacos , Ácidos Picolínicos/farmacologia , Oligoelementos/metabolismo , Análise de Variância , Animais , Relação Dose-Resposta a Droga , Fígado/química , Fígado/metabolismo , Masculino , Ratos , Ratos Wistar , Espectrofotometria Atômica , Fatores de Tempo , Oligoelementos/análise
20.
Ann Cardiol Angeiol (Paris) ; 60(3): 173-5, 2011 Jun.
Artigo em Francês | MEDLINE | ID: mdl-21276951

RESUMO

Cardiac haemangiomas are rare benign primitive tumors. We are reporting the case of a 67-year-old woman presenting with a haemangioma of the right atrium. This tumor was discovered by echocardiography because of cerebral strokes. The magnetic resonance imaging determined the characteristics of the tumor. It was completely resected through a right atrial approach. This was a round mobile mass, pediculed and implanted at the inferior area of the interatrial septum. The histopathological analysis revealed a cavernous haemangioma.


Assuntos
Átrios do Coração , Neoplasias Cardíacas/diagnóstico , Hemangioma Cavernoso/diagnóstico , Idoso , Infarto Cerebral/diagnóstico , Infarto Cerebral/etiologia , Ecocardiografia , Feminino , Átrios do Coração/patologia , Átrios do Coração/cirurgia , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/cirurgia , Septos Cardíacos/patologia , Septos Cardíacos/cirurgia , Hemangioma Cavernoso/complicações , Hemangioma Cavernoso/patologia , Hemangioma Cavernoso/cirurgia , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Recidiva
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